Abstract 11P
Background
We aimed to establish a predictive model enabling gynecologists to assess risk and minimize overtreatment among cervical intraepithelial neoplasia (CIN) 2 or 3 patients.
Methods
We conducted a retrospective cohort study of 311 women diagnosed with CIN2 or CIN3 by colposcopy-directed biopsy before surgical treatment. Univariate and multivariate logistic regression analyses were performed to identify independent overtreatment-associated predictors. We also employed E-value analysis to evaluate the effect of unmeasured confounding variables. Overtreatment was defined as surgical specimens diagnosed with negative or CIN1 pathology.
Results
Among the 311 CIN2/3 women, 103 patients (33.1%) showed CIN 1 or less in the surgical specimens. In multivariate analysis, CIN2 biopsy (odds ratio [OR], 3.1; 95% confidence interval, [CI], 1.9 - 5.2; P < 0.001) and non-high-grade cytology (OR, 3.3; 95% CI, 1.5 - 7.2; P = 0.003) were independent predictors for overtreatment. Furthermore, in 258 patients with non-high-grade cytology, overtreatment occurred in 95 (36.8%) patients, where CIN2 biopsy (OR, 2.8; 95% CI, 1.7 - 4.9; P < 0.001) and human papillomavirus (HPV) integration-negative or low-grade HPV integration-positive results (OR, 4.9; 95% CI, 1.1 - 21.7; P = 0.039) were independent indicators for overtreatment. Based on E-value analysis, our study findings were robust to potential unmeasured confounding variables.
Conclusions
HPV integration status may serve as a good predictor for overtreatment in women with non-high-grade cytology. In women with non-high-grade cytology, HPV integration status may be a good predictor for overtreatment.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.